Arthroscopic Management of Ulnocarpal Impaction Syndrome and Ulnar Styloid Impaction Syndrome.

Both ulnocarpal impaction syndrome and ulnar styloid impaction syndrome can produce ulnar wrist pain. The definition and clinical differentiation are explained. The relevant anatomy, biomechanics, causes, diagnosis, and arthroscopic treatments, as well as the surgical indications, techniques, and outcomes of these syndromes are discussed in detail.

Coronal Fractures of the Scaphoid: A Review.

Coronal (or frontal plane) fractures of the scaphoid are distinctly uncommon. There are few published reports of coronal fractures of the scaphoid. This fracture is often missed on the initial X-ray films.

The management of digital nerve injuries.

A tension-free coaptation is a key factor for the successful outcome of any nerve repair. A variety of host factors influence the outcome of digital nerve repair more than the type of repair per se. Although autologous graft remains the reference standard for reconstruction of any critical digital nerve defect, allografts and conduits have assumed an increasing role.

Scapholunate and lunotriquetral injuries: arthroscopic and open management.

It has become clear that the stability of the scapholunate joint is not dependent wholly upon the scapholunate interosseous ligament but rather upon both primary and secondary stabilizers, which form a scapholunate ligament complex. Each case of scapholunate instability is unique and therefore should be treated with tissue-specific repairs, which may partly explain why a single procedure cannot successfully restore joint stability in every case. Not all lunotriquetral ligament tears are traumatic.

Use of arthroscopy for the treatment of scaphoid fractures.

Arthroscopy allows the surgeon to use smaller incisions and still have predictable outcomes in the treatment of scaphoid fractures. Similar to large joint arthroscopy, the ability to visualize the fracture site allows one to not only fine tune the reduction and to assess the vascularity of the fracture fragments but to evaluate and treat any associated soft tissue injuries that may affect the end result. Specialized equipment and a basic knowledge of wrist arthroscopy however are required.

The role of arthroscopy in trapeziometacarpal arthritis.

Background: Trapeziometacarpal (TM) arthroscopy should be viewed as a useful minimally invasive adjunctive technique rather than the operation itself since it allows one to visualize the joint surface under high-power magnification with minimal disruption of the important ligamentous complex. Relatively few articles describe the arthroscopic treatment of TM osteoarthritis (OA) and the arthroscopic anatomy of the TM joint. There is lingering confusion as to whether soft tissue interposition and K-wire fixation of the joint are needed and whether the outcomes of arthroscopic procedures compare to the more standard open techniques for TM arthroplasty.

Current innovations in wrist arthroscopy.

It has become clear that the stability of the scapholunate joint does not depend wholly on the scapholunate interosseous ligament, but rather on both primary and secondary stabilizers, which form a scapholunate ligament complex. Each case of scapholunate instability is unique and should be treated with tissue-specific repairs, which may partly explain why one procedure cannot successfully restore joint stability in every case. Wrist arthroscopy has a pivotal role in both the assessment and treatment of the scapholunate ligament complex derangements.

Scaphoid fractures: what's hot, what's not.

The scaphoid is the most commonly fractured carpal bone of the wrist. It is an unusual carpal bone in that it bridges both the proximal and the distal rows; this subjects it to continuous shearing and bending forces. Approximately 80% of the scaphoid is covered by cartilage, which limits its ligamentous attachment and vascular supply.

Arthroscopic reduction and percutaneous fixation of fifth carpometacarpal fracture dislocations.

Arthroscopy of the first carpometacarpal (CMC) joint has become routine. Similar techniques can be applied to fracture dislocations involving the fifth CMC joint. This situation is one whereby arthroscopy is definitely of benefit, because the articular fracture fragment is often volar, and difficult to visualize and reduce from a dorsal approach.

Arthroscopic evaluation of the foveal attachment of the triangular fibrocartilage.

Anatomical and biomechanical studies have highlighted the importance of the deep attachment of the TFCC for maintaining stability of the distal radioulnar joint (DRUJ). The standard arthroscopic assessment of the TFCC does not allow one to definitively determine whether the deep fibers are indeed intact, and establishing the diagnosis of a foveal detachment remains an exacting challenge. DRUJ arthroscopy is useful to assess the foveal fibers in any patient with DRUJ instability and can aid in the surgical decision making.